1. Field of the Invention
This invention relates generally to methods and apparatus for evacuating surgical smoke from an operative site, and more specifically to such apparatus and methods which are adapted for laparoscopic surgery.
2. Discussion of the Prior Art
Laparoscopic surgery has become increasingly popular as a less invasive technique for performing abdominal surgery. Trocars are commonly used to puncture the lapra or abdomen and establish a working channel into the abdominal cavity. A particular operation may require several trocars, each providing access for one or more instruments involved in the surgery. For example, an endoscope may be inserted in one trocar while retractors, scalpels, staplers, and other surgical devices are individually inserted through other trocars.
As part of the surgical process, the abdomen is typically inflated with an insufflation gas which tends to separate the interior organs and also to provide a generally enlarged cavity within which to perform the surgery. Laparoscopes which are commonly used in this type of surgery are configured to permit introduction of the insufflation gas directly into the abdominal cavity. The trocars are constructed with seals which prevent the escape of the insufflation gasses both in the presence and absence of an instrument.
When a particular surgery requires that tissue be cut, lasers and electrocautery devices are often preferred as they are easily manipulated and produce relatively clean cuts. They also have a cauterizing effect and therefore limit bleeding. However, cutting with lasers and electrocautery devices often produces smoke and, if the cut tissue is diseased, the smoke may contain toxic, odiferous, and otherwise undesirable contaminants.
The removal and filtration of this smoke is important, since this smoke tends to cloud the surgeon's view of the operative site. In spite of these significant needs to remove the smoke, this is not accomplished without considerable complication. Due to the confines of the abdomen, there is very little access to the surgical site, and the trocars are jealously reserved for instruments more directly associated with the surgery.
In the past, the contaminated surgical smoke has been evacuated by opening the stopcock on one of the trocars and letting the insufflation gas carry the smoke into the operating room. This not only slows the surgery requiring that the abdominal cavity be again insufflated, but it also subjects the surgeon and his staff to the smoke contaminants. Recirculating systems have been used which incorporate two trocars in a closed system. The smoke is withdrawn through one trocar, typically using a probe, and then filtered and reintroduced through the other trocar. Although the smoke in this recirculation system is filtered, the toxic gasses that result from both laser and electrocautery surgery are not filtered and consequently are recirculated back to the patient.
A smoke evacuation kit of the past has also been provided for use with an elongate probe. This probe has been adapted for insertion through the seals of the trocar and into the working channel in order to reach the operative site. This type of smoke evacuation probe is particularly undesirable, since it occupies the working channel rendering the trocar useless for other surgical devices.